SUPPLIER APPLICATION FORM

Transcription

1 Creditor Code Allocated: SUPPLIER APPLICATION FORM The Supplier Application Form is an application to be registered on the Vaal University of Technology (VUT) database and must be completed in full by all prospective suppliers. The form consist of sections A to G. Section A, B, C, D, E, F and G must be completed in full and submitted together with all required substantiating documentation as outlined in Section E in order for the application to be considered. Section A - Contact Details Section B - Company Information Section C - Occupational Health and Safety (where necessary) Section D - Conditions of Purchase Section E - Documentation Required Section F - Supplier Questionnaire Section G - Declaration of interest by Supplier Section H - For Office use only When Consortium/Joint Ventures/Sub-Contractors are making an application, each party must separately submit a completed Supplier Application Form together with substantiating documentation. Joint Ventures should indicate the basis of agreement. Incomplete or incorrectly submitted application forms will not be considered Please initial each page of the application form. TAX CLEARANCE CERTIFICATE REQUIREMENTS It is a condition of this application that the tax of the successful applicant must be in order, or that satisfactory arrangements have been made with South African Revenue Service (SARS) to meet the applicant s tax obligations. The original Tax Clearance Certificate must be submitted. Failure to submit the original and valid Tax Clearance Certificate will result in the invalidation of the application. Certified copies of the Tax Clearance Certificate are not acceptable. When Consortia/Joint Ventures/Sub-contractors are involved, each party must submit a separate Tax Clearance Certificate. A Tax Clearance Certificate as requirement is also applicable to foreign suppliers. Tax Clearance Certificates are obtained from any SARS office nationally. Any arrangement with SARS such as a dispute of whatever nature must be supported by written proof form SARS for consideration. Vanderbijlpark Campus - Private Bag X021 - Vanderbijlpark Andries Potgieter Blvd South Africa - Tel: +27(0) Fax: +27(0)

2 Page 2 of 8 SUPPLIER LIST APPLICATION PLEASE STATE TYPE OF SERVICE OR GOODS TO BE PROVIDED: REGISTERED NAME OF BUSINESS: TRADING AS NAME: PREVIOUS NAME(S) OF BUSINESS: PHYSICAL ADDRESS: SECTION A: CONTACT DETAILS POSTAL ADDRESS: (This is the address to which written correspondence will be directed) POSTAL CODE: POSTAL CODE: TELEPHONE NUMBER OF BUSINESS: TOLL FREE NUMBER: SALES PERSON CONTACT NUMBER: SALES PERSON ADDRESS: SALES PERSON FAX NUMBER: ACCOUNTS DEPARTMENT CONTACT PERSON: CONTACT NUMBER: ACCOUNTS DEPARTMENT ADDRESS: WEBSITE ADDRESS:

3 Page 3 of 8 COMPANY REGISTRATION NUMBER: ID NUMBER (SOLE TRADER) PLEASE ATTACH A CERTIFIED COPY OF ID VAT NUMBER: TYPE OF BUSINESS: Example: Close Corporation BUSINESS CLASSIFICATION: Example: Manufacturing MEMBER OF ANY PROFESSIONAL BODY: YES NO SECTION B: COMPANY INFORMATION PLEASE INDICATE (X) THE CAMPUSES WHERE YOUR BUSINESS IS WILLING AND CAPABLE OF SUPPLYING: VANDERBIJLPARK CAMPUS SECUNDA CAMPUS EDUCITY CAMPUS (Vanderbijlpark) BANK INFORMATION BANK: BRANCH CODE: BANK ACCOUNT NUMBER: UPINGTON CAMPUS DAVEYTON CAMPUS BRANCH NAME: ACCOUNT TYPE: VUT S TERMS OF PAYMENT IS 30 DAYS FROM DATE OF STATEMENT LIST ALL DIRECTORS, SHAREHOLDERS, MEMBERS. (Attach your own list if the space provided is inadequate) NAME POSITION OCCUPIED ID NUMBER CITIZENS DATE OWNERSHIP LIST OF CUSTOMERS: (For reference purpose) NAME CONTACT PERSON CONTACT NUMBER ADDRESS Can we contact any of the references provided? YES NO SECTION C: SAFETY Do you conduct your business in compliance with the requirement of the Occupational Health and Safety Act? (OHS Act No. 85 of 1993) YES/NO Are you registered and in good standing with the Compensation Commissioner? (Compensation for Occupational Injuries and Diseases Act No. 130 of 1993) YES/NO If YES, Please attach a copy of valid letter of Good Standing. Please note that this is compulsory for all maintenance and building contractors. (Note: Failure to provide a valid letter of Good Standing when required will result in your Application not being considered.)

4 Page 4 of 8 SECTION D: CONDITIONS OF PURCHASES IMPORTANT CONDITIONS PERTAINING TO PURCHASE ORDERS 1. The seller shall bear the risk of goods being damaged, lost or destroyed until delivery to VUT is effected and receipt thereof is acknowledged. 2. The seller shall make provision for suitable packaging and preservation in all quotations. Unless otherwise stated all packaging containers and material shall become property of VUT upon delivery. 3. Unless otherwise stated, all goods shall be new and of the best quality. Goods shall be subject to approval by VUT at all times. The seller shall not be released from its obligations in respect of suitability of the materials and / or the quality of the goods by reason of the fact that VUT made no objection, even though the said goods may have been inspected by VUT or by reason of the fact that delivery thereof was taken by or on behalf of VUT. 4. Should the seller be unable to fulfil its obligations in terms of the order, it shall advise VUT to the effect in writing. In which case VUT reserves the right to cancel the order and to purchase the goods from another supplier. The Seller may be obligated to compensate VUT for any differences in the cost. 5. In as much as delivery of the goods may require the Seller or its authorized agent to enter VUT s premises, the Seller shall ensure that such precautions as are necessary to protect life and property anywhere on VUT s premises are taken, and the Seller shall be liable to VUT for injury to any person, or damage to VUT s property caused by or incidental upon negligence or default on the part of the Seller or its authorized agent. 6. VUT s order number and VAT number must appear on the Delivery Note and Tax Invoice. Any Tax Invoices and Delivery Notes without an order number will be ignored and returned to your company. Tax Invoices without order numbers are seen as private agreements with individuals. 7. No alterations to an order may be made without the written approval of the Procurement Department of VUT. 8. Part deliveries will be accepted only under exceptional circumstances. Payment thereof will be made only when ALL goods / services have been delivered. 9. VUT reserves the right to cancel any order in the event where the goods or services are not delivered by the agreed date. 10. It is a firm VUT requirement that all prospective Suppliers must complete a Supplier List Application form in full to be registered on its database. 11. All invoices must be forwarded to the address below: VAAL UNIVERSITY OF TECHNOLOGY Creditors Department Department of Finance AW Building Private Bag X021 Vanderbijlpark Should the Seller accept the order, or should the order not be returned within 10 days of the date thereof, it shall be assumed that the conditions as set out in the paragraphs above are binding. 13. It is the Suppliers responsibility to inform VUT of any changes of contact details, company details or banking details. 14. Payment will be made thirty days after date of statement. Name: Position: In Block Letters Signature: Date:

5 Page 5 of 8 SECTION E: DOCUMENTATION REQUIRED Please tick documents submitted 1. Company Registration Documents (Select relevant form of ownership) 1.1 Sole Proprietor Certified copy of Owners ID/Passport 1.2 Close Corporation Certified copies of Member(s) ID/Passport Certified copy Certificate of Incorporation (aka CK) Certified copy Founding Statement 1.3 Private Company (PTY) LTD Certified copies Shareholder s ID/Passport Certified copies Memorandum & Article of Association Certified copies Share Certificates Certified copy Certificate of Incorporation 1.4 Section 21 Company Certified copies Member(s) ID/Passport Certified copy Memorandum & Article of Association Certified copy Certificate of incorporation 1.5 External Company (Non South African) Certified copies Shareholder s ID/Passport Certified copy Certificate of Registration (CM49) Certified copy Details/register of Directors (CM29) Certified copy Registered Address in South Africa (CM22) 2. Certified and Valid copy BBBEE Certificate (to be submitted annually) 3. Company Profile 4. Proof of Address (for example a Municipality Bill) 5. If you are registered with any Professional Body please add Certificate and/or documentation. 6. Valid ORIGINAL SARS Tax Clearance Certificate (to be submitted annually) 7. Letter confirming banking details from your Bank on a bank letterhead, stamped by the bank, not older than six months

6 Page 6 of 8 SECTION F: SUPPLIER QUESTIONNAIRE 1. Do you have an effective procedure to monitor Customer Satisfaction? Please state full particulars thereof: YES NO 2. Do you have a Quality Management System in place to manage all work procedures? Please specify: The Quality Management System specified above should incorporate product, processes, systems, facilities and Staff. Provide comprehensive details below on how each of these are controlled and assessed: Quality planning and part assurance? (Product, Processes, Systems, Facilities and Staff) 2.2. Logistics; Performance; and Delivery? (Product, Processes, Systems, Facilities and Staff) 2.3. Reliability? (Product, Processes, Systems, Facilities and Staff) 2.4. Formalised problem-solving process? (Product, Processes, Systems, Facilities and Staff) 2.5. After-sales support: the ability to provide spare-part provision over set time-frames and to keep good price stability; details of warranties on products and/ or services, etc.

7 Page 7 of 8 SECTION G: DECLARATION OF INTEREST BY SUPPLIER DECLARATION OF INTEREST BY A SUPPLIER WISHING TO CONDUCT BUSINESS WITH THE VAAL UNIVERSITY OF TECHNOLOGY 1. Any legal person may make an offer or offers in terms of an invitation to tender or apply to be listed as a Supplier to the Vaal University of Technology. In view of possible allegations of favouritism, VUT requires full disclosure of any relationship the applicant or its employees may have with VUT. in light hereof, it is required that the applicant through the authorised signatory take an oath in declaring its interest where: 1.1. The legal person on whose behalf the application is signed, has a relationship with a person/persons who are/is involved in the evaluation and/or adjudication of the application, or where it is known that such relationship exists between the person or persons for or on whose behalf the declarant acts and persons who are involved with the evaluation and/or adjudication of the application A person or person in a managerial position of the legal person on whose behalf the application is signed has a relationship (family, friend or other) with a VUT employee. 2. In order to give effect to the above, the following questionnaire must be completed and submitted with the bid Are you or any person connected with the Applicant employed by VUT? YES NO If the answer to the question is yes, please state full particulars thereof: 2.2. Do you, or any person connected with the Applicant, have any relationship (family, friend or other) with a person employed by VUT and who may be involved with the evaluation and/or adjudication of the application? YES NO If the answer to the question is yes, please state full particulars thereof: 2.3. Are you, or any person connected with the Application, aware of any relationship (family, friend or other) between the applicant and any person employed by VUT who may be involved in the evaluation and/or adjudication of the tender? YES NO If the answer to the question is yes, please state full particulars thereof:

8 Page 8 of 8 DECLARATION I, THE UNDERSIGNED (NAME) IN MY CAPACITY AS CERTIFY THAT THE INFORMATION IN PARAGRAPHS 2.1 TO 2.3 ABOVE IS CORRECT. I ACCEPT AND ACKNOWLEDGE THAT THE VAAL UNIVERSITY OF TECHNOLOGY MAY TAKE FURTHER ACTION AGAINST ME, INCLUDING REMOVAL FROM THE VAAL UNIVERSITY OF TECHNOLOGY DATABASE, AND REJECT THIS APPLICATION SHOULD THIS DECLARATION PROVE TO BE FALSE. I TAKE NOTE OF THE FACT THAT IF INCORRECT INFORMATION IS SUPPLIED, THE VAAL UNIVERSITY OF TECHNOLOGY RESERVE THE RIGHT TO CANCEL/ TERMINATE ANY ORDER/CONTRACT PREVIOUSLY AWARDED TO THE APPLICANT THE VAAL UNIVERSITY OF TECHNOLOGY RESERVES THE RIGHT TO AUDIT ALL INFORMATION SUPPLIED ABOVE. NAME: SIGNATURE CONTACT DETAILS: Phone, Fax number and Address POSITION: DATE: I/We, the undersigned, in my/our capacity as duly authorized representative(s) of (name of company/enterprise) hereby declare the facts and information supplied in this questionnaire are true and correct in every respect. Signed at (town/city) on this day of 20 Signature: Capacity: Initials and Surname in Block Letters Signature: Capacity: Initials and Surname in Block Letters PLEASE RETURN THE COMPLETED DOCUMENTS TO SUPPLY CHAIN MANAGEMENT SECTION AT THE FOLLOWING ADDRESS PHYSICAL ADDRESS VAAL UNIVERSITY OF TECHNOLOGY Supply Chain Management Section Supplier Application Form AW Building, Room AW001 Andries Potgieter Bolulevard Vanderbijlpark 1911 POSTAL ADDRESS VAAL UNIVERSITY TECHNOLOGY Supply Chain Management Section Supplier Application Form Private Bag X021 Vanderbijlpark 1900 SECTION H: FOR OFFICE USE ONLY Approved by: Database and Contracts Manager: Captured By: Creditor Code Allocated: Date: Date: